James Manuen Deng is holding his sobbing two-year-old son Garang, who is wrapped in bandages and blankets. The sick child - named after the late southern rebel leader John Garang - nearly died before being admitted to the therapeutic feeding centre in Nyamlell in Aweil North, a county in Northern Bahr el Ghazal.

Deng is a member of the Dinka ethnic community in the southern Sudanese state of Northern Bahr el Ghazal, which comprises the counties of Aweil North, East, South and West. Deng fled his village during the war-induced famine that ravaged the region in 1988 and claimed approximately 70,000 lives. He returned home in March, on the run again, this time fleeing the escalating violence in the neighbouring state of South Darfur. 

"I decided to come because the situation was very bad in Darfur," Deng said. "Garang's twin brother had died already, and I was afraid my three other boys would die, too. We arrived in Arial Biam [12 hours’ walk from Nyamlell] without anything, and I have shame, as I am dependent on the community. They have nothing themselves, and because their food is running out, they don't share anymore."

Deng initially refused to bring Garang to the therapeutic feeding centre. He was afraid that during his absence his other two sons would die from starvation. Faced with this impossible choice, he decided to let Garang die. Only after the feeding centre agreed to provide food for all three children did Deng come to Nyamlell to get treatment for Garang.

Northern Bahr el Ghazal faces the same problems that are encountered across southern Sudan as it emerges from a 21-year civil war. The rural economy was destroyed during the fighting, and agricultural practices are still so rudimentary that malnutrition is chronic between May and August, the months before the next harvest, when the previous year's food has already run out. 

To make things worse, lack of access to clean water and the nearly total absence of primary healthcare makes children very vulnerable. Year after year, disease-induced malnutrition rates in Northern Bahr el Ghazal are among the worst in South Sudan. Aid agencies fear that the thousands of deprived Dinkas who have recently started to arrive in the area from Darfur and Khartoum will increase the pressure on the region's limited resources.

"People are coming, but nobody is giving support," said Ngong Deng Gum, commissioner of Aweil North. "After the [north-south] peace agreement was signed [in January 2005], people forgot about them. They came back without anything and need help to get back on their feet."

Displaced coming home

Sudan's southern civil war displaced approximately 3.8 million people within the country, according to United Nations estimates. Two million of them are displaced in southern Sudan, while 1.8 million eke out a living in settlements for the internally displaced around the capital, Khartoum.

Louis Hoffmann, head of the South Sudan office of the International Organisation for Migration (IOM), estimates that there are between 80,000 and 90,000 displaced Dinka from Bahr el Ghazal in Darfur, "the vast majority" originating from Aweil North and East. The Sudanese government put the number as high as 300,000, but no international organisation has been able to confirm this. 

No large-scale return movements from Darfur to South Sudan took place immediately after the signing of the peace agreement. According to aid workers, the first groups of displaced Dinka who tested the waters in Northern Bahr el Ghazal in 2005 were "a little shocked about the local conditions" and came back to Darfur. Their opinion changed, however, following a general deterioration of security in Darfur and a series of targeted attacks on Dinka settlements from January 2006.

Former residents of Beliel camp for the internally displaced near Nyala, the capital of South Darfur, reported that Janjawid - government-aligned Arab militia - had attacked the camp. According to Margaret Yamaha, field coordinator for the UN Office for the Coordination of Humanitarian Affairs (OCHA) for Aweil West and North, Dinka returnees from El Ferdose, Abu Matariq and El Da'ein - east of Nyala - all mentioned an increase in intimidation, attacks, killing and rape.

Peter Ngong Yel, a 34-year-old Dinka man who was abducted by Arab cattle herders of the Rizzeigat community in 1984 and eventually made his way to Beliel camp, said that armed men would come at night and loot animals and other belongings of the camp residents, shooting anybody who resisted. "A Janjawid killed my niece when they tried to steal her goat," he said. "Although he was caught, he didn't even get arrested."

In mid-March, according to Hoffmann, the IOM grew concerned about the rapid buildup of returning Dinka on the bank of the Kiir River, near the border between South Darfur and Northern Bahr el Ghazal. "Besides the 3,000 people IOM helped to return [from Darfur] in April, we have assisted about 4,500 spontaneous returns to get off the river," Hoffmann said. In addition, approximately 13,000 people from Khartoum had returned to the area in 2006, he estimated. 

"The absorption capacity in south Sudan is generally limited and we wanted to make sure that the numbers were manageable, but the pace of spontaneous returns to this region [Northern Bahr el Ghazal] has picked up. The numbers are higher than we expected," Hoffman said. Almost daily, an overloaded bus from Khartoum arrives at the banks of the Nyamlell river, with beds, chairs, bicycles and other belongings of returnees piled high on top of its roof.
Aliza Kuol, a 25-year-old mother of four who was born and raised in Khartoum, arrived in Nyamlell on 14 May. "I don't know how to cultivate, but I have made my decision to come home, and I will struggle. I hope to build a house and settle with my family," she said.

The timing of a large number of these returns was not ideal, Hoffmann observed, and many would not return in time to plant and build shelters before the start of the rainy season.

Food insecurity

Large numbers of Dinka are returning empty-handed to one of the most food-insecure areas of southern Sudan, just before the beginning of the hunger season.

"You came with nothing, so you'll leave with nothing," one Dinka returnee quoted armed Darfurian men as saying when they prevented the returnees from taking home their animals and other belongings.

At the therapeutic feeding centre in Nyamlell run by the international NGO Concern, there are currently eight little patients with their parents. Five of the children have recently returned from Darfur. Teshome Feleke, the NGO's nutrition coordinator, said apart from the eight children in the clinic, approximately 200 children were receiving therapeutic feeding and 2,250 other people - about 90 percent of them under age five - received supplementary feeding. 

"The number of admissions into our feeding programmes in February, March and April this year were between 73 and 80 percent higher than during the same time last year," Feleke said. "The main reason is the increase in the return population."

In February, well ahead of the hunger season, global acute malnutrition rates were already 18 percent, which is above the emergency threshold of 15 percent. "The food of the last harvest ran out in April," Feleke said. "From now on, the majority of the population does not have food at all."

Water and healthcare

The recurrent high malnutrition rates among young children in Northern Bahr el Ghazal are not simply a result of the lack of food, however. 

Mathilde Berthelot, field coordinator for Médecins Sans Frontières (MSF) France, in Aquem town in Aweil East said the lack of access to clean water and the absence of primary healthcare were the main reasons for the high malnutrition rates. "Fifty percent of the children in our clinic are sick because of the bad quality of the water and have diarrhoea," Berthelot said. "As it takes their parents two or three days to reach our clinic, the children are dehydrated when they get here and quickly become malnourished."

A survey carried out by Concern in February showed that 58 percent of the households were using shallow wells or water from riverbanks, while only 42 percent used protected wells. More than 95 percent did not have access to a pit latrine.

"Latrines are rarely used here and women still laugh when men use a latrine," said Henk Meyer, Nyamlell programme coordinator for the NGO Cordaid.

The survey also found that more than 60 percent of the children in Aweil North and West were not fully immunised. In these two counties, the number of people served per clinic was as high as 250,000 - until the only NGO providing primary healthcare in the area pulled out. "You can say that at this moment primary health services are zero in these counties - there are no drugs and no medical care," Feleke observed.

Dinkas not welcome

Although many host communities receive returnees with open arms, there are others that do not. Northern Bahr el Ghazal suffered greatly during the war and famine, and fighting has displaced large parts of the community for decades, disrupting the social structure. As a result, the Dinkas do not always find their relatives when they return to their villages, and host communities are not necessarily inclined to share their dwindling resources with returnees they do not recognise. 

Auen Wol Geng was two when her parents fled the 1988 famine and is now a 20-year-old mother of three girls. She returned from Darfur in May, but found that her relatives had fled as well. The remaining members of her home community in Aweil North do not know who she is. She arrived in her hometown of Gong Machar, at the time when food from the community's previous harvest had just run out. 

Abuk Bung Ayei, her one-year-old daughter, has been admitted to a therapeutic feeding centre and is fighting for her life. "The people with whom we are staying asked us to leave as soon as I came back from the clinic - I have nowhere to stay," she said.

In a rapidly growing camp in Nyamlell, about 600 returning Dinka have decided to stay together rather than go home, and an estimated 70 to 80 new returnees are joining them daily. "They don't want to integrate into the resident communities because they are afraid they will not get the assistance from the international community," said Yamaha. "They also want to stay together to provide solidarity to each other. They lack shelter against the rains [which started two weeks earlier], making the children vulnerable to diseases." 

Not all is bad in this new camp in South Sudan, however. Atap Deng Mayar just gave birth to twin daughters - without medical assistance, but they are alive and healthy. Further down, an elderly lady has demarcated a tiny plot between the makeshift shelters and carefully places seeds in the humid soil. When she discovered she is being watched, she gets up, raises her arms and smiles.